Overview
Factitious disorder is a mental health disorder in which a person deceives others by appearing sick, purposely getting sick, or self-injuring. This behavior can range from mild exaggeration of symptoms to severe cases where individuals tamper with medical tests or undergo high-risk procedures to convince others that they need treatment. Factitious disorder is not the same as inventing medical problems for practical benefits, such as avoiding work or winning a lawsuit. People with this disorder know they are causing their symptoms or illnesses but may not understand the reasons for their behaviors or recognize themselves as having a problem. Factitious disorder is challenging to identify and hard to treat. It frequently coexists with other mental health disorders, leading to various complications, including injury or death from self-inflicted medical conditions, severe health problems from infections or unnecessary procedures, alcohol or substance abuse, and significant problems in daily life, relationships, and work. Early recognition and treatment of factitious disorder are essential to prevent these potential dangers.
Understanding the disease
Symptoms
Symptoms of factitious disorder involve mimicking or producing illness or injury or exaggerating symptoms or impairment to deceive others. People with the disorder may have:
- Clever and convincing medical or psychological problems
- Extensive knowledge of medical terms and diseases
- Vague or inconsistent symptoms
- Conditions that get worse for no apparent reason
- Conditions that don't respond as expected to standard therapies
- A poor sense of identity or self-esteem
- Personality disorders
- Depression
- Desire to be associated with doctors or medical centers
- Work in the health care field Factitious disorder is a rare mental health disorder where individuals deceive others by appearing sick, purposely getting sick, or self-injury. It is important to note that factitious disorder is not the same as inventing medical problems for practical benefit, such as getting out of work or winning a lawsuit. Complications of factitious disorder may include injury or death from self-inflicted medical conditions, severe health problems, loss of organs or limbs, alcohol or substance abuse, and significant problems in daily life, relationships, and work.
Risk Factors
The risk factors for developing factitious disorder are not clearly established due to its complex nature and the unknown cause. However, the following factors may play a role:
- Poor sense of identity or self-esteem
- History of personality disorders
- Depression
- Desire to be associated with doctors or medical centers
- Working in the healthcare field Factitious disorder is considered rare, and it can be difficult to estimate its prevalence due to the use of fake names, visiting multiple hospitals and doctors, and the fact that some individuals may never be identified.
Development
The document does not provide a clear answer on how various factitious disorders develop. It mentions that the cause of factitious disorder is unknown and that the disorder is considered rare. Factitious disorder is a complex mental health condition, and its development may be influenced by a combination of genetic, psychological, and environmental factors. It is important to note that each individual's experience with factitious disorder may differ, and a professional evaluation is necessary for proper diagnosis and understanding of the specific factors contributing to the development of the disorder.
Assessment and Diagnosis
Triage
If you suspect a loved one may be exaggerating or faking health problems, it may be helpful to have a gentle conversation about your concerns. Avoid anger, judgment, or confrontation. Encourage healthy and productive activities and offer support and caring. If possible, assist in finding treatment. If the situation is severe or persists, it would be advisable to consult a medical professional for further evaluation and guidance.
Diagnosis
Diagnosing factitious disorder is often challenging because people with this condition are skilled at faking various diseases and conditions. It can be difficult to gather information about their medical history due to the use of multiple doctors, fake names, and privacy regulations. The diagnosis is based on identifying symptoms that are made up rather than the person's intent or motivation. A doctor may suspect factitious disorder if the person's medical history doesn't make sense, there is no believable reason for an illness or injury, the illness doesn't follow the usual course, or there is a lack of healing for no apparent reason despite appropriate treatment. The doctor may also use the criteria for factitious disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
Management and Treatment
Complications
Potential complications of factitious disorder include:
- Injury or death from self-inflicted medical conditions
- Severe health problems from infections or unnecessary surgery or other procedures
- Loss of organs or limbs from unnecessary surgery
- Alcohol or other substance abuse
- Significant problems in daily life, relationships, and work
- Abuse when the behavior is inflicted on another Factitious disorder can lead to severe consequences, and it is crucial to seek medical and psychiatric help for proper diagnosis and treatment to prevent these complications.
Treatment
Treating factitious disorder can be challenging, as it often involves addressing underlying emotional and psychological issues. Here are some treatment options for factitious disorder:
- Psychotherapy: Talk therapy, such as cognitive-behavioral therapy, may help individuals with factitious disorder to develop coping skills and better manage their thoughts and emotions. Family therapy may also be suggested to address family dynamics and relationships.
- Medications: In some cases, medications may be prescribed to help manage symptoms of depression, anxiety, or other mental health disorders that may be co-occurring with the factitious disorder.
- Hospitalization: In severe cases, a temporary stay in a psychiatric hospital may be necessary for safety and treatment. It's essential to note that treatment may not be accepted or may not be helpful, especially for people with severe factitious disorder. In such cases, the goal may be to avoid further invasive or risky treatments. If the factitious disorder is imposed on others, the doctor may assess for abuse and report it to the appropriate authorities, if indicated. Lifestyle changes and self-help strategies can also be beneficial for individuals with factitious disorder. These may include:
- Sticking to a treatment plan, attending therapy appointments, and taking medications as directed
- Having a medical gatekeeper to manage medical care
- Remembering the risks associated with self-harm or unnecessary medical procedures
- Not running from medical professionals or seeking care in new locations
- Connecting with others and building supportive relationships It's important to work closely with a mental health professional experienced in treating factitious disorder to develop a personalized treatment plan that addresses the individual's unique needs and circumstances.
Preparing for medical consultation
To prepare for an appointment for factitious disorder, make a list of your loved one's health history, including health complaints, diagnoses, medical treatments, and procedures. Note any current behaviors or circumstances that may be concerning. Also, compile key points from their personal history, such as abuse or trauma during childhood and significant recent losses. Be prepared to help your loved one sign releases of information to access their records and communicate with other healthcare professionals. If possible, take notes during the appointment or bring a family member or friend to help remember important information.